The Senate bill enacts its health insurance reforms primarily by amending Part A of Title XXVII of the Public Health Service Act. Conforming amendments in section 1562 apply Part A to ERISA plans (except for sections 2716 and 2718 and others that don’t apply to group health plans), and to insurers in the individual market. […]
Transparency and disclosure are vital, although largely ignored, issues in health care reform. Health care is the most expensive thing that we as a nation consume, and one of the most dangerous. We spend over 17% of our national income on health care. Far more Americans die each year from medical errors than from auto […]
Section 2719 of the Senate Patient Protection and Affordable Care Act, HR 3590, provides for appeals of coverage determinations and claims. This section explicitly applies to group health plans and health insurance issuers offering group or individual insurance coverage. Section 1551(a) of the bill incorporates the definitions found in 42 U.S.C. § 300gg-91, which defines […]
See Ruth Marcus’ op ed this morning (November 25) in the Washington Post quoting Walter Dellinger, Laurence Tribe, and Jack Balkin supporting the constitutionality of the mandate.
Posted in Legal Issues ;
Another feature of the Senate bill that compares unfavorably with the House bill is its confusing definitions of insurance coverage. The House bill recognizes one category of private insurance, a “qualified health benefits plan,” which employers are obligated to provide and individuals to buy. This term is used throughout the bill. Only grandfathered plans are […]
In my post of November 16, Returning to the Articles of Confederation, I compared the position that I expected the Senate bill to take on the role of the states in implementing health reform unfavorably to the approach taken by the House bill. The language of the Senate bill is now available, and, unfortunately, it […]
According to the Wall Street Journal of November 18, the latest front of the health care debate is a charge that people who refuse to buy health insurance could, under the House bill, spend five years in prison. The article quotes Rep. Peter Roskam (R. Ill.) as stating “if you don’t comply with the individual […]
In recent days, Mark Hall, Richard Johnson, and Peter Jacobson have all offered opinions as to how HR 3962, if enacted, would affect ERISA preemption of state tort claims against insurers. Let me offer a fourth opinion. First, remember that ERISA tort liability preemption is based primarily on section 502 of ERISA (29 USC 1132). […]
A week ago the House of Representatives adopted HR 3962, the “Affordable Health Care for America Act.” In the very near future, the Senate will begin consideration of some version of the “America’s Healthy Future Act” or the “Affordable Health Choices Act.” Although we do not know the exact language of the Senate bill, its […]
As you all know, the House passed HR 3962, the Affordable Health Care for America Act, late Saturday night, November 7, by a vote of 220 to 215. In doing so, it adopted a handful of amendments. The most important amendment was the Stupak amendment, which the House adopted by a vote of 240 to […]
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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.